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Endometriosis is the presence of functioning endometrium (gland and stroma) in sites other than uterine mucosa, usually in the pelvis, causing dysmenorrhea, dyspareunia, menstrual irregularities, and infertility. case report: A 27-year-old, had caesarean section 11 months ago presented to Obstetrics and Gynaecology clinic with cyclical bleeding from her surgical scar from ten months. she noted bleeding from the small nodule over the healed pfannenstial scar on day of her menses. Examination revealed a small reddish nodule 0.5 cmx0.5 cm, non-tender, with two blackish dots on it. transabdominal ultrasound examination revealed that the nodule confined at the subcutaneous tissue, above the rectus. Ahmad Akram Omar1, Mohd Shukri Othman2, Pek Sung Hoo3, Erinna Mohamad Zon4, Ahmad Amir Ismail1, Rahimah Abdul Rahim1, Nik Rafiza Afendi1, Adibah Ibrahim5 Affiliations: 1Senior lecturer, Obstetrics and Gynaecology Department, School of Medical Science, University Sains Malaysia, Kota Bharu, Kelantan, Malaysia; 2Professor, Obstetrics and Gynaecology Department, School of Medical Science, University Sains Malaysia, Kota Bharu, Kelantan, Malaysia; 3Clinical lecturer, Obstetrics and Gynaecology Department, School of Medical Science, University Sains Malaysia, Kota Bharu, Kelantan, Malaysia; 4Specialist trainee, Obstetrics and Gynaecology Department, School of Medical Science, University Sains Malaysia, Kota Bharu, Kelantan, Malaysia; 5Associate Professor, Obstetrics and Gynaecology Department, School of Medical Science, University Sains Malaysia, Kota Bharu, Kelantan. Corresponding Author: Pek Sung Hoo, Clinical lecturer, Obstetrics and Gynaecology Department, School of Medical Science, University Sains Malaysia, Kota Bharu, Kelantan, Malaysia. Received: 20 August 2017 Accepted: 26 December 2017 Published: 11 April 2018 Diagnosis of scar endometriosis was made. she had wide local excision and recovered well. the histological examination was consistent with scar endometriosis. conclusion: scar endometriosis is a very rare condition. Women in the reproductive age with swelling, pain and discharge at the scar following surgery should be suspected for scar endometriosis.

Menstruation from the pfannenstial scar: A case of rare presentation of atypical endometriosis